| NPI | 1376807354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 13133) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 13133) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2025-07-24 |