| NPI | 1518004464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 14113) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 253641) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2021-04-01 |