| NPI | 1760987630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 75185) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A175589) |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2025-12-22 |