| NPI | 1295752822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD065489L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036094854) |
| 207P00000X Emergency Medicine (Licence: PA MD065489L) | |
| 207Q00000X Family Medicine (Licence: OH 35.093067) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2021-04-05 |