| NPI | 1619136793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2013019668) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS015490) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2014-08-19 |