| NPI | 1770922668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD175400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60611663) |
| 207P00000X Emergency Medicine (Licence: PA MD455390) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2022-11-27 |