| NPI | 1295091858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101255022) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 62258) |
| 207P00000X Emergency Medicine (Licence: OH 35.126519) | |
| 207P00000X Emergency Medicine (Licence: FL ME156514) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2024-02-23 |