| NPI | 1295978815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 255007) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 23191) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2022-12-06 |