| NPI | 1770514861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.116376) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 47744-020) |
| 207P00000X Emergency Medicine (Licence: TX N1385) | |
| 207P00000X Emergency Medicine (Licence: WA MD00046759) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-04-24 |