| NPI | 1477812170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A180202) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2021-00892) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: NC 2021-00892) | |
| 207P00000X Emergency Medicine (Licence: MO 2019009735) | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2022-07-11 |