| NPI | 1801832050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD00019185) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00019185) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-03-07 |