| NPI | 1578821286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A126499) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 279590) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2016-10-18 |