| NPI | 1194982207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS015065) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012027) |
| Enumeration Date | 2008-05-18 |
| Last Update Date | 2021-01-09 |