| NPI | 1255656724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 265691) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 52752) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2016-04-21 |