| NPI | 1295793610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61005307) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX K1874) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2023-05-31 |