| NPI | 1356576516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 115815) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT013024) |
| 207P00000X Emergency Medicine (Licence: ME DO2971) | |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2023-10-12 |