| NPI | 1285053793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD210332) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60763763) |
| 207P00000X Emergency Medicine (Licence: WA ML 60475688) | |
| Enumeration Date | 2014-04-11 |
| Last Update Date | 2026-04-27 |