| NPI | 1225473788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 283292-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR 195093) |
| 207P00000X Emergency Medicine (Licence: ID 15057) | |
| 207P00000X Emergency Medicine (Licence: WA 61006404) | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2022-02-04 |