| NPI | 1245326040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME 015071) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 15954) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-02-04 |