| NPI | 1093120347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD458700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT205922) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2021-01-09 |