| NPI | 1437391604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60455426) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD157239) |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2014-05-14 |