| NPI | 1841721586 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A175468)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 60266)  | 
| Enumeration Date | 2017-03-24 | 
| Last Update Date | 2025-02-27 |