| NPI | 1811948094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00045459) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA MD00045459) |
| 207R00000X Internal Medicine (Licence: WA MD00045459) | |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2019-06-24 |