| NPI | 1275689549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60077695) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD UMPS) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2024-02-15 |