| NPI | 1700383098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301514129) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A165140) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2025-11-21 |