| NPI | 1760420343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS013704) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA pending) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2021-02-24 |