| NPI | 1871028670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A166845) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R76062) |
| Enumeration Date | 2017-04-29 |
| Last Update Date | 2022-07-05 |