| NPI | 1497405377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 34440) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042.0018467) |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2025-10-10 |