| NPI | 1609220078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 65561) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036153699) |
| 207P00000X Emergency Medicine (Licence: PA MT210382) | |
| 207P00000X Emergency Medicine (Licence: VA 0101269845) | |
| 207P00000X Emergency Medicine (Licence: IN 01084380A) | |
| 207P00000X Emergency Medicine (Licence: MD D90393) | |
| 207P00000X Emergency Medicine (Licence: MO 2021040501) | |
| 207P00000X Emergency Medicine (Licence: NY 333569) | |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2025-01-07 |