| NPI | 1114002920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q8553) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00033913) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2024-01-02 |