| NPI | 1386671402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60376719) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101235362) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2013-08-29 |