| NPI | 1164985966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME162172) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 41777) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-03-04 |