| NPI | 1538338512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD17741) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 19592) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2019-05-03 |