| NPI | 1699932392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD 75437) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012256) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2023-11-03 |