| NPI | 1699193979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61440052) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0116028145) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2023-10-20 |