| NPI | 1710418397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 20519) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042.0015510) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2022-04-13 |