| NPI | 1578712006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 03439) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012737) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2024-04-24 |