| NPI | 1912394800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A155406) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 309389) |
| Enumeration Date | 2015-04-19 |
| Last Update Date | 2022-10-10 |