| NPI | 1538514435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 20470) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 277968) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2020-06-16 |