| NPI | 1295312718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD27365) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 33215) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-02-24 |