| NPI | 1679621619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A91328) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 13231) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2017-11-21 |