| NPI | 1538556410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME149249) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 274525) |
| Enumeration Date | 2015-04-18 |
| Last Update Date | 2021-12-28 |