| NPI | 1194068247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME133946) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 28250) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2024-02-05 |