| NPI | 1659669018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101019428) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.011750) |
| 207P00000X Emergency Medicine (Licence: NV DO2371) | |
| 207P00000X Emergency Medicine (Licence: CA 20a14057) | |
| 207P00000X Emergency Medicine (Licence: TX r4592) | |
| 207Q00000X Family Medicine (Licence: CA 20a14057) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: CA 20a14057) | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2018-04-20 |