| NPI | 1255783494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: WA MD60942762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60942762) |
| 2086H0002X Surgery, Hospice and Palliative Medicine (Licence: WA MD60942762) | |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2021-01-04 |