| NPI | 1093205247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A181329) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD471828) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2025-10-07 |