| NPI | 1194059543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD442283) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R70194) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2025-04-03 |