| NPI | 1669827143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 20544) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042.0014786) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2022-08-18 |