| NPI | 1720616923 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A192780)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A192780)  | 
| Enumeration Date | 2020-04-01 | 
| Last Update Date | 2024-10-07 |