| NPI | 1073770400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD178898) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2012-0479) |
| 207P00000X Emergency Medicine (Licence: CO 50485) | |
| 207P00000X Emergency Medicine (Licence: ID M-12317) | |
| 207P00000X Emergency Medicine (Licence: CA 148073) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2022-07-21 |