| NPI | 1124077599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2006-00748) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT182972) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-06-26 |