| NPI | 1659012136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.153148) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A197199) |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2025-08-14 |