| NPI | 1407870330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 62616) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AS A96799) |
| 207P00000X Emergency Medicine (Licence: RI MD11583) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-07-28 |