| NPI | 1548298243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 14662) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 043854) |
| 207P00000X Emergency Medicine (Licence: MA 231205) | |
| 207P00000X Emergency Medicine (Licence: ME TD111057) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2025-05-16 |