| NPI | 1912907775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 83332) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS009396L) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2021-01-27 |