| NPI | 1922216795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A10809) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R833) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2011-07-25 |