| NPI | 1932631348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME157068) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 84237) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2022-10-12 |