| NPI | 1861604944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR 159327) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA 60082368) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2016-04-15 |