| NPI | 1629116058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A8452) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101016056) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2009-09-04 |