| NPI | 1740249226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 222871) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042-0013299) |
| 207P00000X Emergency Medicine (Licence: CT 44481) | |
| 207R00000X Internal Medicine (Licence: MA 222871) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2020-05-22 |