| NPI | 1215162078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME134968) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N8487) |
| 207P00000X Emergency Medicine (Licence: PA MT195368) | |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2018-06-14 |