| NPI | 1265638035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 340375) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012268) |
| 207P00000X Emergency Medicine (Licence: NV DO3481) | |
| 207P00000X Emergency Medicine (Licence: TX N9580) | |
| 207P00000X Emergency Medicine (Licence: OR DO212431) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2025-02-07 |