| NPI | 1831403054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 256956) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A 111717) |
| 207P00000X Emergency Medicine (Licence: RI MD16150) | |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2022-03-10 |