| NPI | 1922341718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA OP60872193) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA OP60872193) |
| 207R00000X Internal Medicine (Licence: WA OP60872193) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2020-12-03 |