| NPI | 1710957600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 146546) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB03987300) |
| 207P00000X Emergency Medicine (Licence: CT 000173) | |
| 207P00000X Emergency Medicine (Licence: FL OS6160) | |
| 207P00000X Emergency Medicine (Licence: IL 36117553) | |
| 207P00000X Emergency Medicine (Licence: MI 5101017159) | |
| 207P00000X Emergency Medicine (Licence: CA 20A9968) | |
| 207P00000X Emergency Medicine (Licence: UT 6452013) | |
| 207P00000X Emergency Medicine (Licence: DE C20008472) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2021-03-23 |