| NPI | 1417957218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME44821) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD425285) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2020-10-13 |