| NPI | 1912153396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2011011572) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C175824) |
| Enumeration Date | 2008-08-17 |
| Last Update Date | 2022-05-24 |