| NPI | 1518233089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP60628281) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS017313) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2016-09-01 |