| NPI | 1275780256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60676986) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 249854) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2021-05-12 |