| NPI | 1881790392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME138099) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC 035384) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2021-08-01 |