| NPI | 1881078707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A152262) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2015021362) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2025-05-01 |