| NPI | 1578882759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 4835882-1204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 13545) |
| 207P00000X Emergency Medicine (Licence: NV do1736) | |
| 207P00000X Emergency Medicine (Licence: AZ 005541) | |
| 207P00000X Emergency Medicine (Licence: FL OS22331) | |
| 207P00000X Emergency Medicine (Licence: CO CDR.0005025) | |
| 207P00000X Emergency Medicine (Licence: GA 103271) | |
| 207P00000X Emergency Medicine (Licence: ID 6271859) | |
| 207P00000X Emergency Medicine (Licence: NE NA4312003) | |
| 207P00000X Emergency Medicine (Licence: WA DO.OP.61677642-IMLC) | |
| 207Q00000X Family Medicine (Licence: MT MED-PHYS-COM-LIC-152) | |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2025-06-25 |