| NPI | 1932762366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: CA 180362) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 180362) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2025-08-06 |