| NPI | 1023179355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101252430) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT188518) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2022-05-11 |