| NPI | 1023270774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60204584) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 125054778) |
| 207P00000X Emergency Medicine (Licence: GU EMTL-2020-015) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2021-05-06 |