| NPI | 1578523577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID O-272) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA OP00001738) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2019-04-16 |