| NPI | 1699708271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA MD50106) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 67740) |
| 207P00000X Emergency Medicine (Licence: VA 0101278138) | |
| 207P00000X Emergency Medicine (Licence: TX J9904) | |
| 207P00000X Emergency Medicine (Licence: MN 62091) | |
| 207P00000X Emergency Medicine (Licence: KY 43172) | |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: TX J9904) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2024-03-04 |