| NPI | 1649219239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 20487) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN BC1030509) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2007-12-04 |