| NPI | 1265666085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.30752) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME 114660) |
| 207P00000X Emergency Medicine (Licence: NC 2016-00905) | |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2024-01-20 |