| NPI | 1013302900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R7531) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA 0101260913) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TN 54888) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NM MD2021-0064) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX R7531) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: VA 0101260913) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: TN 54888) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: NM MD2021-0064) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2022-06-22 |