| NPI | 1154718450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 274476) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 25672) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2024-08-14 |