| NPI | 1184660136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS012995) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 4239) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2024-02-01 |