| NPI | 1295726446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61137334) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 2685) |
| 207P00000X Emergency Medicine (Licence: CA G82224) | |
| 207P00000X Emergency Medicine (Licence: NY 320293) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2023-01-30 |