| NPI | 1639639784 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A179576) | 
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CA A179576) | 
| Enumeration Date | 2019-03-24 | 
| Last Update Date | 2025-10-01 |