| NPI | 1013272152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60847089) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 005549) |
| Enumeration Date | 2012-07-04 |
| Last Update Date | 2023-08-03 |