| NPI | 1376905570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 2024-01750) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02005902A) |
| 207P00000X Emergency Medicine (Licence: TX S0697) | |
| 207P00000X Emergency Medicine (Licence: IL 036151575) | |
| 207P00000X Emergency Medicine (Licence: NC 2024-01750) | |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2024-09-18 |