| NPI | 1811208663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 75361) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A117906) |
| 207P00000X Emergency Medicine (Licence: TN MD51572) | |
| Enumeration Date | 2010-06-27 |
| Last Update Date | 2024-02-26 |