| NPI | 1184983850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD464001) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301100833) |
| 207P00000X Emergency Medicine (Licence: HI MD22105) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: HI MD22105) | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2022-02-22 |