| NPI | 1528046554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX J8743) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD153416) |
| 207P00000X Emergency Medicine (Licence: HI 12372) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX J8743) | |
| 208D00000X General Practice (Licence: OR MD153416) | |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2024-02-07 |