| NPI | 1255956520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A185348) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA A185348) |
| 207P00000X Emergency Medicine (Licence: TX W6358) | |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2026-10-01 |