| NPI | 1700151917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C192925) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 285720) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2024-03-04 |