| NPI | 1336645613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2021-0226) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A206071) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2025-12-01 |