| NPI | 1689092108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 272918) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 20628) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2024-08-19 |