| NPI | 1205451440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A22456) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT020374) |
| Enumeration Date | 2020-06-13 |
| Last Update Date | 2025-05-14 |