| NPI | 1407016405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N2400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT188801) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2024-09-12 |