| NPI | 1962445569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 078785) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD424684) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-03-30 |