| NPI | 1578977997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A159798) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL38088) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2021-05-17 |