| NPI | 1528629276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-46276) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT219280) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2022-07-15 |