| NPI | 1518164532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS015077) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101016761) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-04-15 |