| NPI | 1033345855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT194613) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P1438) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2024-09-25 |