| NPI | 1316986805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35061655) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 54491) |
| 207P00000X Emergency Medicine (Licence: TX R4489) | |
| 207P00000X Emergency Medicine (Licence: NY 60169114) | |
| 207P00000X Emergency Medicine (Licence: CA G-00063490) | |
| 207P00000X Emergency Medicine (Licence: FL ME133220) | |
| 207P00000X Emergency Medicine (Licence: KY 49303) | |
| 207P00000X Emergency Medicine (Licence: MO 2016022007) | |
| 207P00000X Emergency Medicine (Licence: NC 00061) | |
| 207P00000X Emergency Medicine (Licence: PA MD054415L) | |
| 207P00000X Emergency Medicine (Licence: SC MD40001) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-09-21 |