| NPI | 1184667677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD032793E) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D29282) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2021-10-05 |