| NPI | 1073615837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 17396) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A97132) |
| 207P00000X Emergency Medicine (Licence: LA 205265) | |
| 207P00000X Emergency Medicine (Licence: FL ME120901) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2016-07-27 |