| NPI | 1649401829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 260998) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD451632) |
| 207P00000X Emergency Medicine (Licence: NH 18809) | |
| 207P00000X Emergency Medicine (Licence: MI 4301104712) | |
| 207P00000X Emergency Medicine (Licence: NJ 25MA09507700) | |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2024-03-21 |