| NPI | 1386055853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO2336) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 25507) |
| Enumeration Date | 2014-05-18 |
| Last Update Date | 2026-08-18 |