| NPI | 1326087925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00040182) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 25357) |
| 207P00000X Emergency Medicine (Licence: CA 54616) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-11-22 |