| NPI | 1548612245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME178869) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME139282) |
| 207P00000X Emergency Medicine (Licence: PA 472210) | |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2026-06-17 |