| NPI | 1912356395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2020011600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A20849) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2023-06-22 |