| NPI | 1164614012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD460476) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ PG 80909) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2022-07-21 |