| NPI | 1083815906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD453671) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME106288) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2022-01-13 |