| NPI | 1649478249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS014674) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102206563) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2022-08-17 |