| NPI | 1912391467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61521329) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL Me135390) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2024-10-29 |