| NPI | 1265840789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 274002) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 18702) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2023-09-15 |