| NPI | 1083783617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME159522) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101057806) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2023-03-16 |