| NPI | 1184121410 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A181993) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101272580) | 
| Enumeration Date | 2018-04-12 | 
| Last Update Date | 2024-03-19 |