| NPI | 1982067328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD.MD.61377871) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D87188) |
| 207P00000X Emergency Medicine (Licence: PA MD470442) | |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2023-08-15 |