| NPI | 1568555845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A87877) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI 15431) |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2026-01-12 |