| NPI | 1669576005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME122909) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G58815) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2021-04-19 |