| NPI | 1962540765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A103672) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 230648) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2015-02-26 |