| NPI | 1457507378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036158629) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 26154) |
| 207P00000X Emergency Medicine (Licence: NC 2017-02012) | |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2023-10-05 |