| NPI | 1558757880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A155648) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME144940) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2025-12-01 |