| NPI | 1023285517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1018126) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME143598) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2024-07-10 |