| NPI | 1801993688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101221374) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-089818) |
| 207P00000X Emergency Medicine (Licence: MO R2P95) | |
| 207P00000X Emergency Medicine (Licence: OH 35-05-8601) | |
| 207P00000X Emergency Medicine (Licence: KS 04-23610) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-09-08 |