| NPI | 1891710588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME127705) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 024723) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2023-01-27 |