| NPI | 1588156343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP61186080) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT018588) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-08-08 |