| NPI | 1043478878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34009268) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS15556) |
| 207P00000X Emergency Medicine (Licence: PA OS014401) | |
| 207P00000X Emergency Medicine (Licence: IA DO-05207) | |
| 207P00000X Emergency Medicine (Licence: ID OC-0016) | |
| 207P00000X Emergency Medicine (Licence: KY 04092) | |
| 207P00000X Emergency Medicine (Licence: NY 294790-01) | |
| 207P00000X Emergency Medicine (Licence: CA 20A11755) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2023-09-19 |