| NPI | 1558345934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 61354-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 0036-098097) |
| 207P00000X Emergency Medicine (Licence: CO 41764) | |
| 207P00000X Emergency Medicine (Licence: IN 01054196A) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2025-10-09 |