| NPI | 1376587899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA MD00017511) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00017511) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2023-11-03 |