| NPI | 1316926439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD449077) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0056811) |
| 207P00000X Emergency Medicine (Licence: DE C1-0006529) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2020-12-19 |