| NPI | 1699917625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME155694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 45498) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2023-06-22 |