| NPI | 1942564943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA RTP 005634) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60757748) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2019-02-14 |