| NPI | 1841473352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0069723) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD440038) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2021-01-09 |