| NPI | 1053721167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 3292) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT015766) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2023-08-04 |