| NPI | 1063661296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60322364) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 13622) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2016-03-17 |