| NPI | 1700815842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME136641) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 82031) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2023-02-09 |