| NPI | 1710929732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 00026233) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME142878) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2024-02-29 |