| NPI | 1134111305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD058712L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD058712L) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2024-11-19 |