| NPI | 1922485671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A17124) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 007559) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2019-07-26 |