| NPI | 1083095897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD211266) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD467678) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2022-08-31 |