| NPI | 1134655418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A203053) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD469057) |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2025-10-01 |