| NPI | 1194707604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2004010784) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A75100) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2025-04-07 |