| NPI | 1629077052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 153440) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 912) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2023-05-10 |