| NPI | 1609097898 |
|---|---|
| Former Name | WESLEY B. BLAKE VON RIEDENAUER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301086703) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MS 14789) |
| 208600000X Surgery (Licence: MS 14789) | |
| 208600000X Surgery (Licence: ND 20800) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 1930) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME115495) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: ID MC-2691) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MS 14789) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MS 14789) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2025-02-10 |