| NPI | 1447838826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 77558) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 34308) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CT 77558) | |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-07-02 |