| NPI | 1366452120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00046406) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD-22646) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2025-12-04 |