| NPI | 1982853206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A111987) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT190827) |
| 207P00000X Emergency Medicine (Licence: PA MD438215) | |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2015-01-18 |