| NPI | 1538507678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME128384) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD455885) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2020-12-07 |