| NPI | 1720030422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 57397-21) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS013189) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2022-05-05 |