| NPI | 1417339748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 2779-021) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS018472) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2023-10-18 |