| NPI | 1174548622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G86323) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-077473) |
| 207P00000X Emergency Medicine (Licence: PA 044039) | |
| 207P00000X Emergency Medicine (Licence: OH 35060068) | |
| 207P00000X Emergency Medicine (Licence: MA 205659) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2024-03-14 |