| NPI | 1629092788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 34341) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA G142756) |
| 207P00000X Emergency Medicine (Licence: CA G142756) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2026-05-07 |