| NPI | 1487947495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 53247) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 14101) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2026-01-30 |