| NPI | 1700011798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 16127) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012852) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2023-01-24 |