| NPI | 1891711743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036-110486) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 38590) |
| 207P00000X Emergency Medicine (Licence: MO 2009010649) | |
| 207P00000X Emergency Medicine (Licence: WI 4845120) | |
| 207P00000X Emergency Medicine (Licence: OH 35.093955) | |
| 207P00000X Emergency Medicine (Licence: VA 0101248860) | |
| 207P00000X Emergency Medicine (Licence: TN 46549) | |
| 207P00000X Emergency Medicine (Licence: MI 4301094015) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2017-02-06 |