| NPI | 1386621225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD062969L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA FG1327128) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2022-04-19 |