| NPI | 1831547116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S7902) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 82833) |
| 207P00000X Emergency Medicine (Licence: FL 140306) | |
| 207P00000X Emergency Medicine (Licence: TN 0000058981) | |
| 207P00000X Emergency Medicine (Licence: CO 0063771) | |
| 207P00000X Emergency Medicine (Licence: KY 52300) | |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2023-07-07 |