| NPI | 1033156740 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A65615)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WY 9806A)  | 
| 207P00000X Emergency Medicine (Licence: MT MED-PHYS-LIC-34023)  | |
| 207P00000X Emergency Medicine (Licence: UT 9064844-1205)  | |
| 207P00000X Emergency Medicine (Licence: NM MD2014-0724)  | |
| 207P00000X Emergency Medicine (Licence: NV 15481)  | |
| 207P00000X Emergency Medicine (Licence: CO DR.0054437)  | |
| 207P00000X Emergency Medicine (Licence: ID M-12661)  | |
| 207P00000X Emergency Medicine (Licence: WA MD60476217)  | |
| 207P00000X Emergency Medicine (Licence: HI MD-18004)  | |
| 207P00000X Emergency Medicine (Licence: OR MD168822)  | |
| 207P00000X Emergency Medicine (Licence: AZ 49508)  | |
| 207P00000X Emergency Medicine (Licence: NY 281239)  | |
| 207P00000X Emergency Medicine (Licence: FL ME125239)  | |
| 207P00000X Emergency Medicine (Licence: PA MD455902)  | |
| Enumeration Date | 2006-06-01 | 
| Last Update Date | 2019-08-19 |