| NPI | 1942529334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 53251) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT 197118) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2018-11-15 |