| NPI | 1407822760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101249730) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD447082) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2021-03-24 |