| NPI | 1043265804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D75037) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 26624) |
| 207P00000X Emergency Medicine (Licence: WI 44713-020) | |
| 207P00000X Emergency Medicine (Licence: IL 035105392) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-05-08 |