| NPI | 1821190471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 9701627) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD24083) |
| 207P00000X Emergency Medicine (Licence: PA MD059815L) | |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2024-04-01 |