| NPI | 1104864396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: CA G52370) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G52372) |
| 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: WA MD-60135840) | |
| 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: WA MD60135840) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2012-08-21 |