| NPI | 1376953075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD38129) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD461842) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2020-02-05 |