| NPI | 1447647706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61249163) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 55182) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2023-06-14 |