| NPI | 1528290814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS015709) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT013408) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2023-09-15 |