| NPI | 1518374883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME134981) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 31403-R) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2021-03-26 |