| NPI | 1861718587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS016603) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD H74630) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2022-05-19 |