| NPI | 1831693787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 33916) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042.0015341) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-11-22 |