| NPI | 1275037715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 67355) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD61328379) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2023-03-13 |