| NPI | 1992783708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Pending) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME159352) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2024-08-08 |