| NPI | 1508216532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A18211) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151012734) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2020-06-30 |