| NPI | 1538140223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 36547) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P2502) |
| 207P00000X Emergency Medicine (Licence: GA 83775) | |
| 207P00000X Emergency Medicine (Licence: IN 01057915A) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01057915A) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2022-11-02 |