| NPI | 1467072447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT234255) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 324719) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2025-06-13 |