| NPI | 1598712135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 24366) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 37535) |
| 207P00000X Emergency Medicine (Licence: MS 17549) | |
| 207P00000X Emergency Medicine (Licence: CA A96078) | |
| 207P00000X Emergency Medicine (Licence: TN 35848) | |
| 207P00000X Emergency Medicine (Licence: HI 13765) | |
| 207P00000X Emergency Medicine (Licence: FL ME119281) | |
| 207P00000X Emergency Medicine (Licence: KS 04-37095) | |
| 207P00000X Emergency Medicine (Licence: WA 60175689) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2024-05-13 |