| NPI | 1487915757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME144871) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME144871) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MN 63948) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: WI 69374) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL ME144871) | |
| 207P00000X Emergency Medicine (Licence: MI 4301100333) | |
| 207P00000X Emergency Medicine (Licence: MN 63948) | |
| 207R00000X Internal Medicine (Licence: MI 4301100333) | |
| 207R00000X Internal Medicine (Licence: FL ME144871) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2020-08-31 |