| NPI | 1346480308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 127979) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 094686) |
| 207P00000X Emergency Medicine (Licence: NC 96-01157) | |
| 207P00000X Emergency Medicine (Licence: NY 230097) | |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2025-06-02 |