| NPI | 1396834669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042.0013796) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD429506) |
| 207P00000X Emergency Medicine (Licence: DE C1-0008364) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2022-07-21 |