| NPI | 1487682514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP00002097) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036102500) |
| 207P00000X Emergency Medicine (Licence: MN 80845) | |
| 207P00000X Emergency Medicine (Licence: VA 0102209721) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2025-10-22 |