| NPI | 1942697719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A154371) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 19660) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2019-07-01 |