| NPI | 1811308190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A147775) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301105235) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2019-05-29 |