| NPI | 1326570094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME155537) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2020-1001) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2023-07-10 |