| NPI | 1174690192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A70600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0074503) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2025-03-21 |