| NPI | 1023143674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD466504) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0055885) |
| 207P00000X Emergency Medicine (Licence: DC MD32311) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2019-04-05 |