| NPI | 1396974044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 2847) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012880) |
| 207Q00000X Family Medicine (Licence: PA OT012880) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2023-11-29 |