| NPI | 1255868279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME154999) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 35441) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: FL ME154999) | |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2024-05-24 |