| NPI | 1245283241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036168425) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2005-00404) |
| 207P00000X Emergency Medicine (Licence: WA MD61376221) | |
| 207P00000X Emergency Medicine (Licence: KY 46794) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-08-21 |