| NPI | 1710923545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00024071) |
| Additional Taxonomies | 207PT0002X Emergency Medicine Medical Toxicology (Licence: WA 24071) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2013-12-03 |