| NPI | 1316332448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY TP447) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01092044A) |
| 207P00000X Emergency Medicine (Licence: TX W2416) | |
| 207P00000X Emergency Medicine (Licence: TN 76289) | |
| 207P00000X Emergency Medicine (Licence: MN 81361) | |
| 207P00000X Emergency Medicine (Licence: IL 036.177917) | |
| 207P00000X Emergency Medicine (Licence: OH 35C.003548) | |
| 207P00000X Emergency Medicine (Licence: PA MD493029C) | |
| 207P00000X Emergency Medicine (Licence: AL 52633) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2025-12-16 |