| NPI | 1902913080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C130634) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 35725) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 35725) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2023-08-03 |