| NPI | 1750584686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C42306) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: CA C42306) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2025-06-11 |