| NPI | 1083765408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 67086) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 226122) |
| 207P00000X Emergency Medicine (Licence: CA C55169) | |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2024-09-26 |