| NPI | 1003852658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A704030) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME78602) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2026-06-29 |