| NPI | 1629093000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-098626) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 41230) |
| 207P00000X Emergency Medicine (Licence: CO DR-37522) | |
| 207P00000X Emergency Medicine (Licence: MO 116980) | |
| 207P00000X Emergency Medicine (Licence: WA MD00036584) | |
| 207P00000X Emergency Medicine (Licence: UT 327103-1205) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2013-01-23 |