| NPI | 1124656913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME157957) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101279741) |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2024-12-20 |