| NPI | 1265469977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C55113) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD12455) |
| 207P00000X Emergency Medicine (Licence: MS 18800) | |
| 207P00000X Emergency Medicine (Licence: FL ME88472) | |
| 207P00000X Emergency Medicine (Licence: AL 00026822) | |
| 207P00000X Emergency Medicine (Licence: LA MD.15234R) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2021-11-29 |