| NPI | 1982196127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 75898) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A173369) |
| 207P00000X Emergency Medicine (Licence: RI MD19481) | |
| 207P00000X Emergency Medicine (Licence: PA MT215031) | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2023-08-30 |