| NPI | 1356326805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M8025) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA 0023441) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2023-03-07 |