| NPI | 1184980377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C194442) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q7409) |
| 207P00000X Emergency Medicine (Licence: NY 282951) | |
| 2083A0100X Preventive Medicine Aerospace Medicine (Licence: NY 282951) | |
| 2083A0100X Preventive Medicine Aerospace Medicine (Licence: TX Q7409) | |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2024-09-24 |