| NPI | 1538587258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI MD20379) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0083191) |
| 207P00000X Emergency Medicine (Licence: WA MD60857817) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2019-10-22 |