| NPI | 1306475199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 81362) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 1024561) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2025-07-10 |