| NPI | 1467644765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 12614) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A95233) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2025-04-15 |