| NPI | 1477917797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60920069) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R75483) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2024-08-06 |