| NPI | 1336245026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 50711) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA OP00002014) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2025-07-17 |