| NPI | 1821451089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A177078) |
| Additional Taxonomies | 208VP0000X (Licence: CA 177078) |
| 207P00000X Emergency Medicine (Licence: PA FK8182026) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2026-06-22 |