| NPI | 1053993329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD483246) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT222302) |
| 207P00000X Emergency Medicine (Licence: WA MD.MD.61533989) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: WA MD.MD.61533989) | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2024-04-16 |