| NPI | 1700346210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5151013524) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A19364) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2022-05-11 |