| NPI | 1962793869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME119315) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 173062) |
| 207P00000X Emergency Medicine (Licence: PA MD476043) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2024-06-18 |