| NPI | 1073755484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA md60271645) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD1923695) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2019-03-26 |