| NPI | 1508125394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO176228) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A13092) |
| 207P00000X Emergency Medicine (Licence: ID O-1472) | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2022-02-23 |