| NPI | 1902148505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A147389) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 268893) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2021-10-21 |