| NPI | 1326096330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00023171) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: WA MD00023171) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2018-12-05 |