| NPI | 1699156232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT209000) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME138083) |
| 207P00000X Emergency Medicine (Licence: IA MD-45485) | |
| 207P00000X Emergency Medicine (Licence: IN 01080664A) | |
| 207P00000X Emergency Medicine (Licence: MI 4301502249) | |
| 207P00000X Emergency Medicine (Licence: IL 036146890) | |
| 207P00000X Emergency Medicine (Licence: OH 35.138133) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2021-05-21 |