| NPI | 1366404592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: WA MD00040450) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: WA MD00040450) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: WA MD00040450) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2018-04-17 |