| NPI | 1013336718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME135891) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2023-00054) |
| 207P00000X Emergency Medicine (Licence: ME MD22006) | |
| 207P00000X Emergency Medicine (Licence: NY 288550) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2023-04-14 |