| NPI | 1831694801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS021299) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT018254) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2021-09-13 |