| NPI | 1265729362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A152069) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT200573) |
| 207P00000X Emergency Medicine (Licence: PA MT200573) | |
| Enumeration Date | 2011-07-09 |
| Last Update Date | 2026-08-10 |