| NPI | 1356912604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME1673972) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME167397) |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2026-02-26 |