| NPI | 1255317368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2009-0733) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD419703) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2018-10-04 |