| NPI | 1760420236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME124137) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101225442) |
| 207P00000X Emergency Medicine (Licence: UT 12963923-1205) | |
| 207P00000X Emergency Medicine (Licence: MT 114999) | |
| 207P00000X Emergency Medicine (Licence: ID M-16812) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2022-09-28 |