| NPI | 1518909647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P5765) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-105559) |
| 207P00000X Emergency Medicine (Licence: WI 44719-020) | |
| 207P00000X Emergency Medicine (Licence: IN 01054617A) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2022-11-17 |