| NPI | 1407296783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A149143) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301103910) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2019-04-04 |