| NPI | 1497726285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00042843) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2025-0413) |
| 207P00000X Emergency Medicine (Licence: ND PT21783) | |
| 207P00000X Emergency Medicine (Licence: WA MD00042843) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2025-11-18 |