NPI | 1306466925 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61426695) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR 215000) |
Enumeration Date | 2020-04-23 |
Last Update Date | 2025-05-13 |