| NPI | 1265823793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61518915) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 292098) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2024-10-01 |