| NPI | 1831120781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA A90710) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX U6753) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2026-02-16 |