| NPI | 1215998737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA 20A13246) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 227598) |
| 207P00000X Emergency Medicine (Licence: KY 03623) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 227598) | |
| 208D00000X General Practice (Licence: NY 227598) | |
| 207P00000X Emergency Medicine (Licence: IA DO-04697) | |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2019-06-07 |