| NPI | 1730211376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60224723) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A97830) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2019-03-15 |