| NPI | 1942392709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61413019) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME93270) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2025-01-01 |