| NPI | 1114035425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 73763) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301091577) |
| 207P00000X Emergency Medicine (Licence: NY 245493) | |
| 207P00000X Emergency Medicine (Licence: IL 036128086) | |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2020-08-31 |