| NPI | 1386900215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS017486) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA 390200000X.) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2020-10-19 |