| NPI | 1659399418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MO066061L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C10005312) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-01-05 |