NPI | 1538204649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: WA MD00031618) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-9021) |
Enumeration Date | 2007-02-20 |
Last Update Date | 2022-09-28 |