| NPI | 1700449899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 326620) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME165849) |
| 207P00000X Emergency Medicine (Licence: IA MD-52521) | |
| 207P00000X Emergency Medicine (Licence: KY 56985) | |
| 207P00000X Emergency Medicine (Licence: WI 3865-320) | |
| 207P00000X Emergency Medicine (Licence: TN 62279) | |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2024-05-06 |