| NPI | 1073995247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT208573) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 317436) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2023-07-22 |