| NPI | 1124280490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS015414) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012329) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2024-05-22 |