| NPI | 1881185544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT018402) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 19301) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2022-05-12 |