| NPI | 1043673833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 38180) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 25482) |
| 207P00000X Emergency Medicine (Licence: FL ME140457) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2025-10-02 |