| NPI | 1609306828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD61245243) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD197145) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-09-12 |