| NPI | 1982017232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 007628) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS017853) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2021-06-28 |