| NPI | 1952341869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00046141) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00046141) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-09 |