| NPI | 1679739288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME126548) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A110836) |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2026-05-01 |