| NPI | 1720427735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 48716) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 72763) |
| 207P00000X Emergency Medicine (Licence: MO 2016009029) | |
| 207P00000X Emergency Medicine (Licence: IL 036140673) | |
| 207P00000X Emergency Medicine (Licence: TN 54490) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2016-08-15 |