| NPI | 1447298716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD18976) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU M-2028) |
| 207P00000X Emergency Medicine (Licence: WA MD00031735) | |
| 207P00000X Emergency Medicine (Licence: MT MED-PHYS-LIC-43939) | |
| 207P00000X Emergency Medicine (Licence: ID M-13506) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2021-03-15 |