| NPI | 1275896417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT202796) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD18154) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2022-01-03 |