| NPI | 1467102012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A190802) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 76731) |
| Enumeration Date | 2022-03-26 |
| Last Update Date | 2025-09-26 |