| NPI | 1396009098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD457931) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301101003) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2022-07-26 |