| NPI | 1376998849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A17512) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT016941) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2019-10-17 |