| NPI | 1184603557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A7230) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 4685) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2025-03-13 |