| NPI | 1013087485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60990596) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD16726) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-02-24 |