| NPI | 1366692998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN MD36443) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: TN MD36443) |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: AL MD21175) | |
| 207L00000X Anesthesiology (Licence: TN MD36443) | |
| 207L00000X Anesthesiology (Licence: AL MD21175) | |
| 207P00000X Emergency Medicine (Licence: AL MD21175) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TN MD36443) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AL MD21175) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: AL MD21175) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: TN MD36443) | |
| 208D00000X General Practice (Licence: TN MD36443) | |
| 208D00000X General Practice (Licence: AL MD21175) | |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-18 |