| NPI | 1982023800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A139827) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A139827) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2018-06-18 |