| NPI | 1437354081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A112876) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A112876) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2025-10-11 |