| NPI | 1619046489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 15906) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 79728) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2022-01-07 |