| NPI | 1245868553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME160676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 69566) |
| 207P00000X Emergency Medicine (Licence: MN 30862) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-01-10 |