| NPI | 1992852263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS014187) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD H0062850) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2008-12-02 |