| NPI | 1508033036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 17859) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 236748) |
| 207P00000X Emergency Medicine (Licence: NH LT-3750) | |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2016-10-18 |