| NPI | 1144355900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P9342) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD 60082534) |
| 207P00000X Emergency Medicine (Licence: HI MD-15453) | |
| 207P00000X Emergency Medicine (Licence: AK 7871) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2024-04-16 |