| NPI | 1700171279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A12016) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 005621) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2014-12-08 |