| NPI | 1831245349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA 61350329) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 101588) |
| 207P00000X Emergency Medicine (Licence: OH 35.135443) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2022-10-03 |