| NPI | 1518372416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61108167) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD.MD.6108167) |
| 207P00000X Emergency Medicine (Licence: CA A150375) | |
| 207P00000X Emergency Medicine (Licence: WA MD61108167) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2024-02-27 |