| NPI | 1598898157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 50723) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036113693) |
| 207P00000X Emergency Medicine (Licence: IN 01051595A) | |
| 207P00000X Emergency Medicine (Licence: OH 35087543) | |
| 207Q00000X Family Medicine (Licence: IL 036113693) | |
| 207Q00000X Family Medicine (Licence: IN 01051595A) | |
| 207Q00000X Family Medicine (Licence: OH 35087543) | |
| 207Q00000X Family Medicine (Licence: MN 50723) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2008-07-11 |