| NPI | 1487915401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61293664) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A141319) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2022-06-28 |