| NPI | 1508056375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD437829) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT190145) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2024-01-25 |