| NPI | 1134344740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS014145) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: PA OS014145) |
| 207P00000X Emergency Medicine (Licence: PA OT011008) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2022-09-26 |