| NPI | 1528521176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP61256862) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA 61256862) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2024-04-09 |