| NPI | 1720288681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD183368) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00047671) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2024-03-25 |