| NPI | 1134562408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0058488) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA ML60371549) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2021-04-26 |