| NPI | 1558650127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 1558650127) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.099741) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: AZ 1558650127) | |
| 207P00000X Emergency Medicine (Licence: FL ME179507) | |
| 207P00000X Emergency Medicine (Licence: VA 0101268161) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: OH 35.099741) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2026-09-09 |