| NPI | 1003080623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD442848) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 247889) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2022-12-20 |