| NPI | 1669967386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A178477) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2020042730) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2022-07-05 |