| NPI | 1063674075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 35.125338) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 70087) |
| 207P00000X Emergency Medicine (Licence: MI 4301092662) | |
| 207P00000X Emergency Medicine (Licence: MO 2022038128) | |
| 207P00000X Emergency Medicine (Licence: GA 93872) | |
| 207P00000X Emergency Medicine (Licence: IN 01090874A) | |
| 207P00000X Emergency Medicine (Licence: FL ME0160334) | |
| 207P00000X Emergency Medicine (Licence: IL 036.162328) | |
| 207P00000X Emergency Medicine (Licence: ID M-16681) | |
| 207P00000X Emergency Medicine (Licence: AZ 68014) | |
| 207P00000X Emergency Medicine (Licence: MS 30871) | |
| 207P00000X Emergency Medicine (Licence: AR E-15021) | |
| 207P00000X Emergency Medicine (Licence: CA C182974) | |
| 207P00000X Emergency Medicine (Licence: NY 318422) | |
| 207P00000X Emergency Medicine (Licence: NH 22679) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2025-09-04 |