| NPI | 1902836588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00019959) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: WA MD00019959) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2011-12-06 |