| NPI | 1275896797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME123018) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT202022) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2021-10-28 |