| NPI | 1750960597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 75751) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A195440) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2025-07-09 |