| NPI | 1134574122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD467598) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 305521) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MD467598) | |
| 207P00000X Emergency Medicine (Licence: PA MT211617) | |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2021-03-05 |