| NPI | 1558682955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 23371) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD.207257) |
| 207P00000X Emergency Medicine (Licence: FL ME115516) | |
| 207P00000X Emergency Medicine (Licence: TN 54985) | |
| 207P00000X Emergency Medicine (Licence: TX R4955) | |
| 207P00000X Emergency Medicine (Licence: SC 36910) | |
| 207P00000X Emergency Medicine (Licence: OH 35.098136) | |
| 207P00000X Emergency Medicine (Licence: AL MD.33364) | |
| 207P00000X Emergency Medicine (Licence: OH 098136) | |
| Enumeration Date | 2010-06-20 |
| Last Update Date | 2021-03-23 |