| NPI | 1598805483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200300914) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD444249) |
| 207P00000X Emergency Medicine (Licence: NY 220345) | |
| 207P00000X Emergency Medicine (Licence: OH 35.098435) | |
| 207P00000X Emergency Medicine (Licence: IL 036.124282) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2024-07-01 |