| NPI | 1578958021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A161627) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD463469) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2019-08-21 |