| NPI | 1679519532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G64578) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00047253) |
| 207P00000X Emergency Medicine (Licence: TX J7738) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2022-12-02 |