| NPI | 1073176723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 1073176723) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0070336) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2026-07-21 |