| NPI | 1942272984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00049015) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 223325) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2008-07-02 |