| NPI | 1376775536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A122570) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2026-0397) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2026-05-20 |