| NPI | 1437174307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD28003) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-52263) |
| 207P00000X Emergency Medicine (Licence: WA 60476107) | |
| 207P00000X Emergency Medicine (Licence: OK 47018) | |
| 207P00000X Emergency Medicine (Licence: NC 2025-03934) | |
| 207P00000X Emergency Medicine (Licence: MO 2026001102) | |
| 207P00000X Emergency Medicine (Licence: PA MD425791) | |
| 207P00000X Emergency Medicine (Licence: CO CDR.0000811) | |
| 207P00000X Emergency Medicine (Licence: NE CP1834) | |
| 207P00000X Emergency Medicine (Licence: ID MC-0552) | |
| 207P00000X Emergency Medicine (Licence: WY 19161C) | |
| 207P00000X Emergency Medicine (Licence: VA 0101287475) | |
| 207P00000X Emergency Medicine (Licence: TX W2237) | |
| 207P00000X Emergency Medicine (Licence: MI EMC0008439) | |
| 207P00000X Emergency Medicine (Licence: WA MD.MD.60476107) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2026-01-26 |