| NPI | 1184291502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NH 39653) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 39653) |
| 207P00000X Emergency Medicine (Licence: IL 036168304) | |
| 207P00000X Emergency Medicine (Licence: OH 34.017742) | |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2026-07-01 |