| NPI | 1881651644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 034599) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CT 034599) |
| 207R00000X Internal Medicine (Licence: CT 034599) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2021-01-21 |