| NPI | 1992769715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 241979) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 241584) |
| 207P00000X Emergency Medicine (Licence: VT 042.0013085) | |
| 207P00000X Emergency Medicine (Licence: AZ 31217) | |
| 207P00000X Emergency Medicine (Licence: WI 65627-20) | |
| 207P00000X Emergency Medicine (Licence: CT 045844) | |
| 207P00000X Emergency Medicine (Licence: CA A82470) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2025-06-18 |