| NPI | 1386850972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: WA OP60314074) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP60314074) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WA OP60314074) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 34009173) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: WA OP60314074) | |
| 208VP0000X (Licence: OR DO172317) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2022-12-13 |