| NPI | 1114331196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101277935) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301505472) |
| 207P00000X Emergency Medicine (Licence: CA 149253) | |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: MI 4301505472) | |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CA 149253) | |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: VA 0101277935) | |
| 208D00000X General Practice (Licence: MI 4301505472) | |
| 208D00000X General Practice (Licence: VA 0101277935) | |
| 208D00000X General Practice (Licence: CA 149253) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2023-06-29 |