| NPI | 1922325133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042.0015009) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 269673) |
| 207P00000X Emergency Medicine (Licence: OR MD177517) | |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2020-10-27 |