| NPI | 1386930030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60549119) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2014039438) |
| 207P00000X Emergency Medicine (Licence: MO 207P00000X) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2021-04-08 |