| NPI | 1003815515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 19121) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C186856) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2025-12-02 |