| NPI | 1740296383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME93862) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 54534) |
| 207P00000X Emergency Medicine (Licence: RI 16728) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2023-01-09 |