| NPI | 1578957056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A155538) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 56073) |
| 207P00000X Emergency Medicine (Licence: CO 60330) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2019-04-18 |