| NPI | 1356879829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME163577) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT213654) |
| 207P00000X Emergency Medicine (Licence: PA MT213654) | |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2023-07-11 |