| NPI | 1386662302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS8460) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS010305L) |
| 207P00000X Emergency Medicine (Licence: NH 24425) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2024-02-14 |