| NPI | 1881652808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME173110) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 219339) |
| 207P00000X Emergency Medicine (Licence: CT 045548) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2025-08-15 |