| NPI | 1942829254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1015771) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 322340) |
| 207P00000X Emergency Medicine (Licence: IN 01090142A) | |
| 207P00000X Emergency Medicine (Licence: MI 4301511675) | |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2024-04-11 |