| NPI | 1700191285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A124061) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2017-02180) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2018-03-17 |