| NPI | 1275503898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME79188) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD066369L) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2020-11-19 |