| NPI | 1336376078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT013002) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT013002) |
| Enumeration Date | 2009-06-21 |
| Last Update Date | 2020-01-08 |