| NPI | 1598783722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.149581) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 104826) |
| 207R00000X Internal Medicine (Licence: WI 100555) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2024-02-08 |