| NPI | 1033314075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C162827) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08258800) |
| 207P00000X Emergency Medicine (Licence: DE C1-0008482) | |
| 207P00000X Emergency Medicine (Licence: PA MD431275) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2019-09-27 |