| NPI | 1811060882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G202553) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 59597) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2026-08-27 |