| NPI | 1770650640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G83085) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU MTL-2025-020) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2026-01-14 |