| NPI | 1073537395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00044824) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD25968) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2008-07-09 |