| NPI | 1548572431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301096853) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD451652) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2022-07-21 |