| NPI | 1710327481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 313337) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01080816B) |
| 207P00000X Emergency Medicine (Licence: IA MD-45391) | |
| 207P00000X Emergency Medicine (Licence: VA 0101265199) | |
| 207P00000X Emergency Medicine (Licence: WV 28376) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2022-01-10 |