| NPI | 1205003142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 55393-21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036126435) |
| 207P00000X Emergency Medicine (Licence: CA 20A17336) | |
| 207P00000X Emergency Medicine (Licence: OH 34C.000023) | |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2024-03-08 |