| NPI | 1659803328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A19348) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101025417) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2025-05-22 |