| NPI | 1043282742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 17183) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD-065144-L) |
| 207Q00000X Family Medicine (Licence: PA MD065144L) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2023-08-14 |