| NPI | 1013413707 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A165949)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A165949)  | 
| Enumeration Date | 2018-04-02 | 
| Last Update Date | 2025-07-24 |