| NPI | 1174785505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 2601946) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA OP61492300) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2023-10-10 |