| NPI | 1871948836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 64793) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL 127964) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2020-03-20 |