| NPI | 1386059970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60749420) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 74783) |
| 207P00000X Emergency Medicine (Licence: CO DR.0060202) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2022-05-10 |