| NPI | 1033431358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 273890) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2012-00076) |
| 207P00000X Emergency Medicine (Licence: FL ME111129) | |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2018-07-16 |