| NPI | 1871570648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR C5310) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-077829) |
| 207P00000X Emergency Medicine (Licence: FL ME 65943) | |
| 207P00000X Emergency Medicine (Licence: AL 16379) | |
| 207P00000X Emergency Medicine (Licence: CA C42512) | |
| 207Q00000X Family Medicine (Licence: CA C42512) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2019-03-27 |