| NPI | 1760777981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0062556) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125-059363) |
| 207P00000X Emergency Medicine (Licence: CA A129367) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2019-09-06 |