| NPI | 1477715571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 19481) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 239371) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2019-05-20 |