| NPI | 1609361500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A19094) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL UO6172) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2021-10-01 |