| NPI | 1538286208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 1200717) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 53609) |
| 207P00000X Emergency Medicine (Licence: WI 64744) | |
| 207P00000X Emergency Medicine (Licence: NM MD2015-0838) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2021-08-30 |