| NPI | 1922493360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA OP61416104) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA OP61416104) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2025-12-16 |