| NPI | 1154576841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS015076) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT12242) |
| Enumeration Date | 2008-11-21 |
| Last Update Date | 2020-06-24 |