| NPI | 1013544972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME158473) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 1016936) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2024-09-11 |