| NPI | 1235557281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 303737) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 51470) |
| 207P00000X Emergency Medicine (Licence: TN 57915) | |
| 207P00000X Emergency Medicine (Licence: GA 92531) | |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2024-10-11 |