| NPI | 1558980144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2025-00706) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A189394) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2025-07-10 |