| NPI | 1760612378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A121795) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301094919) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2021-12-15 |