| NPI | 1669687885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: SC 37697) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2010-00596) |
| 207P00000X Emergency Medicine (Licence: VA 0101252732) | |
| 207P00000X Emergency Medicine (Licence: GA 59374) | |
| 207P00000X Emergency Medicine (Licence: FL ME114174) | |
| 207P00000X Emergency Medicine (Licence: SC 37697) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2022-12-21 |