| NPI | 1972583748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102203068) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A5282) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2012-09-06 |