| NPI | 1710071733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME163879) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01060456) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-08-07 |