| NPI | 1578675245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 45538) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35081691) |
| 207P00000X Emergency Medicine (Licence: FL ME97390) | |
| 207P00000X Emergency Medicine (Licence: CA A93623) | |
| 207P00000X Emergency Medicine (Licence: PA MD439347) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-07-01 |