| NPI | 1477707685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60247504) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 7471598-1205) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2024-10-23 |