| NPI | 1447540067 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 126109) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 2758) | 
| 207P00000X Emergency Medicine (Licence: NY 320631) | |
| Enumeration Date | 2011-04-15 | 
| Last Update Date | 2023-01-30 |