| NPI | 1700822681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00045198) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00045198) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2017-04-06 |