| NPI | 1275566689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME122116) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 257836) |
| 207P00000X Emergency Medicine (Licence: NV 15205) | |
| 207P00000X Emergency Medicine (Licence: AZ 48777) | |
| 207P00000X Emergency Medicine (Licence: NC 200300721) | |
| 207P00000X Emergency Medicine (Licence: CO DR.0055340) | |
| 207P00000X Emergency Medicine (Licence: VA 0101257604) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-09-10 |