| NPI | 1073134409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA 61406646) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151014440) |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2023-07-08 |