| NPI | 1962880039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A167925) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R74952) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2021-12-01 |