| NPI | 1558590679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A14140) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 249402) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2018-09-25 |