| NPI | 1255302485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GU DO-0024) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 9661) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2025-12-09 |