| NPI | 1538801469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO3949) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A22261) |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2025-08-19 |