| NPI | 1780975805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME147071) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0085809) |
| Enumeration Date | 2011-04-23 |
| Last Update Date | 2021-03-24 |