| NPI | 1841647732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61319016) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 287741) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2022-11-10 |