| NPI | 1184081036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP61438606) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 1700) |
| Enumeration Date | 2016-01-23 |
| Last Update Date | 2024-03-28 |