| NPI | 1922534437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP61113417) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101025127) |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2021-07-26 |