| NPI | 1215256813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS015904) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 006426) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2014-06-11 |