| NPI | 1124241542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD449522) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2014-01238) |
| 207P00000X Emergency Medicine (Licence: PA MD449522) | |
| 207P00000X Emergency Medicine (Licence: MD D0066108) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MD D0066108) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MD D66108) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-02-01 |