| NPI | 1912340233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61047420) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI 18839) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2021-11-19 |