| NPI | 1871657197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 046658) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00028503) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2012-09-12 |