| NPI | 1962482372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2007017246) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02004644A) |
| 207P00000X Emergency Medicine (Licence: IL 036-078771) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2021-02-25 |