| NPI | 1891992095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A111526) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60237865) |
| 207P00000X Emergency Medicine (Licence: MI 4301090563) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2013-02-27 |