| NPI | 1477847994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A124391) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 2639) |
| 207P00000X Emergency Medicine (Licence: NY 320765) | |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2023-01-30 |