| NPI | 1265694574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL ME115662) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME115662) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2021-10-07 |