| NPI | 1013146653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60325597) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R71684) |
| 207P00000X Emergency Medicine (Licence: AZ 45759) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2013-06-09 |