| NPI | 1861466948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A 8288) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA 20A 8288) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2010-04-26 |