| NPI | 1457640500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A124929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 15737) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2025-07-08 |