| NPI | 1881642205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A89200) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A89200) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2026-04-16 |