| NPI | 1780320697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA DO-07009) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151015708) |
| 207P00000X Emergency Medicine (Licence: IN 02008346A) | |
| 207P00000X Emergency Medicine (Licence: IL 036.174423) | |
| 207P00000X Emergency Medicine (Licence: NY 336158) | |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2025-09-02 |