| NPI | 1891953261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 2902) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012709) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2022-01-03 |