| NPI | 1144684523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 63612) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 278056) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MA 278056) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2023-08-31 |