| NPI | 1356667091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 23837) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60519059) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2023-05-03 |