| NPI | 1073838017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101018990) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 59934) |
| 207P00000X Emergency Medicine (Licence: PA OS018184) | |
| 207P00000X Emergency Medicine (Licence: SC DO39065) | |
| 207P00000X Emergency Medicine (Licence: WI 64641-21) | |
| 207P00000X Emergency Medicine (Licence: AZ 009928) | |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2024-10-23 |