| NPI | 1386872869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS015747) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA OP60693700) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2021-12-29 |