| NPI | 1114992302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00048730) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A72102) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2014-09-08 |