| NPI | 1376586198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C52676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 103918) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2025-04-23 |