| NPI | 1699327528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A208084) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME156133) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2026-05-09 |