| NPI | 1972132314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 77522) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 32133) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2024-07-16 |