| NPI | 1922008390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME81601) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD419599) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2021-03-25 |