| NPI | 1023426509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 165030) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME133933) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2018-03-17 |