| NPI | 1235344367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 78714) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA pending) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2026-01-09 |