| NPI | 1629295019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT189238) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N3767) |
| 207P00000X Emergency Medicine (Licence: IN 01088618A) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2023-01-24 |