| NPI | 1780797506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD23740) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA 00045113) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2025-04-25 |