| NPI | 1174901730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS019103) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT016517) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2023-02-09 |