| NPI | 1124234919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS014652) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT011242) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2021-01-02 |