| NPI | 1205840840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P9828) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G83618) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2025-01-22 |