| NPI | 1720426414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 055141) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 255254) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2016-05-27 |