| NPI | 1639176415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A62096) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 9173) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2018-03-17 |