| NPI | 1386891620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS15734) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA OP60652158) |
| 207P00000X Emergency Medicine (Licence: AL DO.1099) | |
| 207P00000X Emergency Medicine (Licence: ID O-0997) | |
| 207P00000X Emergency Medicine (Licence: OH 34.011427) | |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2019-11-18 |