| NPI | 1962761460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101262427) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA a134446) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2022-05-19 |