| NPI | 1679002000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 83528) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT213435) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2021-05-25 |