| NPI | 1982642179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A34155) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 12436) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2017-04-20 |