| NPI | 1386799039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME123769) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 220145) |
| 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: FL ME123769) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME123769) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2024-08-29 |