| NPI | 1598842650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD25192) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD11143507) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |