| NPI | 1871766774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD151204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD433061) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2022-02-01 |