| NPI | 1225370547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 70401) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2016-01031) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: SC 82384) | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2022-04-02 |