| NPI | 1861870875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A16731) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101021970) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2019-10-03 |