| NPI | 1619430964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME158061) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 29277) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2024-03-01 |