| NPI | 1750523478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A112396) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD151030) |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2026-03-25 |