| NPI | 1922202399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C167440) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 240483) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2021-04-09 |