| NPI | 1568982965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A171407) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 271502) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2025-10-10 |