| NPI | 1083716237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD473063) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-29512) |
| 207P00000X Emergency Medicine (Licence: KS 04-29512) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2021-03-08 |