| NPI | 1154333540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA g59961) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: CA G59961) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2026-06-28 |