| NPI | 1215958418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 45646) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 7087) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2023-07-17 |