| NPI | 1962793877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CO DR.0071235) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 21318) |
| 207P00000X Emergency Medicine (Licence: NC 2016-00409) | |
| 207P00000X Emergency Medicine (Licence: NE 27217) | |
| 207P00000X Emergency Medicine (Licence: FL ME133632) | |
| 207P00000X Emergency Medicine (Licence: CO DR.0071235) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2023-11-13 |