| NPI | 1699252460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2024018288) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME162259) |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2024-05-23 |