| NPI | 1851337059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD150570) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00039954) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2014-07-28 |