| NPI | 1285687525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD063950L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35075196O) |
| 207P00000X Emergency Medicine (Licence: WV 24828) | |
| 207P00000X Emergency Medicine (Licence: TX Q0525) | |
| 207P00000X Emergency Medicine (Licence: NE 27930) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2022-07-21 |