| NPI | 1861754970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 57024) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A126866) |
| 207P00000X Emergency Medicine (Licence: CO DR.0056734) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2018-03-17 |