| NPI | 1952924540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1020847) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA MD-51986) |
| 207P00000X Emergency Medicine (Licence: NY 327147) | |
| 207P00000X Emergency Medicine (Licence: IL 036165207) | |
| 207P00000X Emergency Medicine (Licence: CA A191304) | |
| 207P00000X Emergency Medicine (Licence: VA 0101278505) | |
| 207P00000X Emergency Medicine (Licence: WI 82121) | |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2025-06-18 |