| NPI | 1528441052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 21075) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301107667) |
| 207P00000X Emergency Medicine (Licence: CT 60910) | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2023-07-11 |