| NPI | 1922077346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM 85-203) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00033617) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2017-03-22 |