| NPI | 1902023336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C55621) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 89527) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2022-07-25 |