| NPI | 1225007388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: WA 43643) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: UT 2948311205) |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: WA MD00043643) | |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: UT 294831-1205) | |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: WA MD00043643) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: WA 43643) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2023-07-31 |