NPI | 1669001905 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1022892) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 78205) |
Enumeration Date | 2020-04-08 |
Last Update Date | 2025-06-24 |