| NPI | 1780038711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A151155) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-14579) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2019-06-18 |