| NPI | 1437646197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61539807) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 71782) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2025-10-07 |