| NPI | 1114906609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2017-1020) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NC 37998) |
| 207P00000X Emergency Medicine (Licence: IL 036142147) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2018-01-23 |