| NPI | 1730573635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 65600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A146848) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MN 65600) | |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2025-04-02 |