| NPI | 1275567521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME141217) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 207618-1) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-12-20 |