| NPI | 1093033185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 54293) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA 60360729) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2014-09-11 |