| NPI | 1679580831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G78430) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME97711) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-02-04 |