| NPI | 1982643565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP00001658) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP00001658) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA OP00001658) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-08-04 |