| NPI | 1679910558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 132786) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME134568) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2022-10-22 |