| NPI | 1700960549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00047848) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 33861) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2008-04-23 |