| NPI | 1225529167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A163877) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 23601) |
| Enumeration Date | 2018-05-26 |
| Last Update Date | 2026-09-03 |