| NPI | 1043630718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD470578) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 81964) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2021-02-22 |