| NPI | 1720516743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A164295) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT213671) |
| Enumeration Date | 2017-06-03 |
| Last Update Date | 2020-10-28 |