| NPI | 1124057625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C1-0024532) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD053758L) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2021-11-23 |