| NPI | 1417464363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 2833) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A183886) |
| 207P00000X Emergency Medicine (Licence: CA A183886) | |
| Enumeration Date | 2018-01-01 |
| Last Update Date | 2026-07-31 |