| NPI | 1376574160 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WA MD00044507) | 
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NV 20736) | 
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WA MD00044507) | |
| Enumeration Date | 2006-07-06 | 
| Last Update Date | 2022-12-02 |