| NPI | 1851366587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS009894L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL os-13681) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2020-05-13 |