| NPI | 1215905450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0076506) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD070450L) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2019-11-19 |