| NPI | 1770818536 |
|---|---|
| Professional Name | ZACK JOHN BASELLE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q0220) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 90248) |
| 207P00000X Emergency Medicine (Licence: MI 5101018406) | |
| 207P00000X Emergency Medicine (Licence: CA 19564) | |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2022-12-12 |