| NPI | 1679935597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A20603) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS16654) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-08-17 |