| NPI | 1801214275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A150799) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 269282) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2022-04-14 |