| NPI | 1235391079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60201430) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT190979) |
| 207P00000X Emergency Medicine (Licence: PA MD438549) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2022-09-13 |