| NPI | 1255358883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 46670) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A8717) |
| 207P00000X Emergency Medicine (Licence: IL 036-098236) | |
| 207P00000X Emergency Medicine (Licence: IN 02001867A) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2017-04-07 |