| NPI | 1568403830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WY 10806A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A76046) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2021-05-24 |