| NPI | 1811085038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 056420) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD445327) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-04-08 |