| NPI | 1396746756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD418068) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301510966) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2025-09-11 |