| NPI | 1962146787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID 3671269) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 22480) |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2025-09-30 |