| NPI | 1932763547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP61084035) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A20434) |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2023-06-23 |