| NPI | 1255590147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D77514) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD442094) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2022-08-11 |