| NPI | 1487684254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00042271) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 31545) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2013-09-23 |