| NPI | 1649416595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 050770) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 269570) |
| Enumeration Date | 2008-12-24 |
| Last Update Date | 2025-06-25 |