| NPI | 1710374996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D85894) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD467783) |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2021-03-08 |