| NPI | 1750308359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP00002209) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP00002209) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-06-06 |