| NPI | 1497055909 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD447665) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A125405) | 
| 207P00000X Emergency Medicine (Licence: PA 197311) | |
| Enumeration Date | 2010-10-31 | 
| Last Update Date | 2023-11-29 |