| NPI | 1720281249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.097370) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD038031) |
| 207P00000X Emergency Medicine (Licence: MD D0069450) | |
| 207P00000X Emergency Medicine (Licence: NJ 25MA08619500) | |
| 207P00000X Emergency Medicine (Licence: VA 0101246179) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2013-06-07 |