| NPI | 1629281993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 047035) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 257152) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2023-08-22 |