| NPI | 1528235405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 55130) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CT 55130) |
| Enumeration Date | 2008-05-10 |
| Last Update Date | 2025-03-05 |