| NPI | 1790760551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A104178) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 234034) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2011-03-14 |