| NPI | 1083818348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 231148) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 18799) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2019-01-29 |