| NPI | 1134568041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 266590) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT203715) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2018-03-21 |