| NPI | 1407828296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 152223) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042-0015940) |
| 207P00000X Emergency Medicine (Licence: NY 195212) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2022-10-23 |