| NPI | 1154609139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301119203) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT199928) |
| 207P00000X Emergency Medicine (Licence: PA MD458005) | |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2019-11-12 |