| 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 |