| NPI | 1780835298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 33112) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A108778) |
| 207P00000X Emergency Medicine (Licence: SC TL33112) | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2020-12-28 |