| NPI | 1912528373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 94026) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01090100A) |
| 207P00000X Emergency Medicine (Licence: IA MD-52015) | |
| 207P00000X Emergency Medicine (Licence: MI 4301509477) | |
| 207P00000X Emergency Medicine (Licence: FL ME162560) | |
| 207P00000X Emergency Medicine (Licence: NY 330887) | |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2025-03-11 |