| NPI | 1780670950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD28630) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA05815700) |
| 207P00000X Emergency Medicine (Licence: IN 1062722A) | |
| 207P00000X Emergency Medicine (Licence: IL 036083583) | |
| 207P00000X Emergency Medicine (Licence: WI 44817-020) | |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2025-01-08 |