| NPI | 1609187004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 66197) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 19505) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2022-05-03 |