| NPI | 1063574556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 29366) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD429824) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2022-11-28 |