| NPI | 1275062705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME168717) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 303800) |
| 207P00000X Emergency Medicine (Licence: MI 4301112604) | |
| 207P00000X Emergency Medicine (Licence: AZ 60435) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2024-06-22 |