| NPI | 1700945474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE ND-11439-A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA md00043363) |
| 207P00000X Emergency Medicine (Licence: AR E-5163) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2012-06-19 |