| NPI | 1336481878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 17410) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042.0013324) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2016-08-30 |