| NPI | 1073833521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT013544) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT013544) |
| 207P00000X Emergency Medicine (Licence: ME D02598) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2024-11-15 |