| NPI | 1578600342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00037161) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: WA MD00037161) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2023-09-25 |