| NPI | 1316231905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME137811) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN16041) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2022-10-26 |