NPI | 1033748553 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-19784) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 3902000000X) |
207P00000X Emergency Medicine (Licence: WV 4073) | |
207P00000X Emergency Medicine (Licence: VA 0102208469) | |
Enumeration Date | 2020-04-06 |
Last Update Date | 2025-09-23 |