| NPI | 1720466477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61017052) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A155792) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2025-06-09 |