| NPI | 1629271408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C54160) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 234090-1) |
| 207P00000X Emergency Medicine (Licence: VA 0101241979) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2021-12-01 |