| NPI | 1568663698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.205243) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL 105462) |
| 207P00000X Emergency Medicine (Licence: GA 63327) | |
| 207P00000X Emergency Medicine (Licence: NM MD2010-0284) | |
| 207P00000X Emergency Medicine (Licence: MS 27504) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-05-27 |