| NPI | 1750308375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD423030) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT046811T) |
| 207P00000X Emergency Medicine (Licence: VA 0116013343) | |
| 207P00000X Emergency Medicine (Licence: DE C1-0007358) | |
| 207P00000X Emergency Medicine (Licence: DE TP0002885) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2016-10-24 |