| NPI | 1891322129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20793) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151014314) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-10-02 |