| NPI | 1992789804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042-0016416) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A65066) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2022-10-20 |