| NPI | 1336280296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD030562E) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MD030562E) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2022-04-07 |