| NPI | 1467444984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101248320) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: VA 0101248320) |
| 207PS0010X Emergency Medicine Sports Medicine (Licence: VA 0101248320) | |
| 209800000X Legal Medicine (Licence: CA G77118) | |
| 209800000X Legal Medicine (Licence: VA 0101248320) | |
| 202C00000X Independent Medical Examiner (Licence: VA 0101248320) | |
| 207P00000X Emergency Medicine (Licence: MD D84232) | |
| 207P00000X Emergency Medicine (Licence: CA G77118) | |
| 207P00000X Emergency Medicine (Licence: OH 35.070203) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2017-10-15 |