| NPI | 1932387057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A105271) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: CA A105217) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2012-11-13 |