| NPI | 1922233915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SD 8819) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012816) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2019-09-12 |