| NPI | 1538122635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C54872) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 53006) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2025-11-11 |