| NPI | 1467512715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 044695) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 203491) |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2021-10-19 |