| NPI | 1346586625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D96159) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 62551) |
| 207P00000X Emergency Medicine (Licence: GA 86337) | |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2023-08-09 |