| NPI | 1881006336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60901173) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD459343) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2023-12-19 |