| NPI | 1679763353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A120517) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 14203) |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2018-03-17 |