| NPI | 1811968704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G66984) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD16165) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2009-03-19 |