| NPI | 1881911402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A124925) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 256293) |
| 207P00000X Emergency Medicine (Licence: PA MD444611) | |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2020-06-05 |