| NPI | 1649219080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2014-0574) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G45755) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2019-06-25 |