| NPI | 1427360999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A17884) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA4005) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2020-11-09 |