| NPI | 1194353920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD219369) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD70092676) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2026-05-15 |