| NPI | 1245640978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD70024947) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A154489) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2025-10-02 |