| NPI | 1053345868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G61262) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD61127791) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2023-02-17 |