| NPI | 1144273517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60187949) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: MI 061819) |
| 207PE0004X Emergency Medicine Emergency Medical Services (Licence: WA MD60187949) | |
| 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: WA MD60187949) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2022-03-23 |