| NPI | 1902851173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301042724) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA 60303031) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2024-08-12 |