| NPI | 1932131695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101255629) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD073688L) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-06-11 |