| NPI | 1154360071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00037182) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OR MD20885) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2017-04-20 |