| NPI | 1417011164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C142650) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00048104) |
| 207P00000X Emergency Medicine (Licence: NY 233756) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2021-11-30 |