| NPI | 1245298231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD072301L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 30163) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2021-01-15 |