| NPI | 1508047176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD433556) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 044905) |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2021-12-14 |