| NPI | 1043553035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD29210) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD474852) |
| 207P00000X Emergency Medicine (Licence: VA 0101262675) | |
| 207P00000X Emergency Medicine (Licence: MD D0084273) | |
| 207P00000X Emergency Medicine (Licence: WV 29083) | |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2025-10-09 |