| NPI | 1730648585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME150301) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME150301) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2024-08-15 |