| NPI | 1033591086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD488539) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI EMC0005365) |
| 207P00000X Emergency Medicine (Licence: MN 77341) | |
| 207P00000X Emergency Medicine (Licence: KY C2899) | |
| 207P00000X Emergency Medicine (Licence: IN 01079961A) | |
| 207P00000X Emergency Medicine (Licence: IL 036.170829) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: FL ME158432) | |
| 207P00000X Emergency Medicine (Licence: IA MD-53386) | |
| 207P00000X Emergency Medicine (Licence: WI 4584-320) | |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2025-10-21 |