| NPI | 1194012542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 279666) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS016731) |
| 207P00000X Emergency Medicine (Licence: PA OT013928) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2022-10-27 |