| NPI | 1558657882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 33905) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A165678) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2021-09-13 |