| NPI | 1639243140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301076059) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60115775) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2024-02-02 |