| NPI | 1336508043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS018959) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME DO4042) |
| 207Q00000X Family Medicine (Licence: PA OS018959) | |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2025-09-25 |