| NPI | 1851332381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60198552) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 23842) |
| 207P00000X Emergency Medicine (Licence: CO DR.0039927) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-03-03 |