| NPI | 1972879278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS020391) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101019848) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2021-07-01 |