| NPI | 1689830697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q3044) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU m2140) |
| 207P00000X Emergency Medicine (Licence: AK 132749) | |
| 207P00000X Emergency Medicine (Licence: HI 15682) | |
| 207P00000X Emergency Medicine (Licence: WA 60351665) | |
| 207P00000X Emergency Medicine (Licence: NM 2019-0497) | |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2019-12-21 |