| NPI | 1396864963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP60098132) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 4826) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2023-03-07 |