| NPI | 1821528746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 33193) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 271286) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2025-10-10 |