| NPI | 1912951898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A82893) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60757721) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2025-07-31 |