| NPI | 1942524756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2012006517) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD61399073) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2023-04-17 |