NPI | 1255407888 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00031527) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00031527) |
Enumeration Date | 2006-11-27 |
Last Update Date | 2023-03-07 |