| NPI | 1316100183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD470913) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 271428) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2022-04-13 |