| NPI | 1700843166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 214353) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 64730) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2020-02-24 |