| NPI | 1639150709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G25305) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 2744) |
| 207P00000X Emergency Medicine (Licence: NY 320496) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2023-03-15 |