| NPI | 1558545863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036163473) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A102233) |
| 207P00000X Emergency Medicine (Licence: IA MD-53606) | |
| 207P00000X Emergency Medicine (Licence: CT 56051) | |
| 207P00000X Emergency Medicine (Licence: IN 01083556A) | |
| 207P00000X Emergency Medicine (Licence: WI 101460) | |
| 207P00000X Emergency Medicine (Licence: VA 0101275974) | |
| 207P00000X Emergency Medicine (Licence: MO 2023027642) | |
| 207P00000X Emergency Medicine (Licence: MA 274844) | |
| 207P00000X Emergency Medicine (Licence: PA MD473792) | |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2025-08-04 |