| NPI | 1255331203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A8427) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0075037) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2025-05-29 |