| NPI | 1013593839 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A189388) | 
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: CA A189388) | 
| Enumeration Date | 2021-03-22 | 
| Last Update Date | 2025-06-13 |