| NPI | 1518106871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD445231) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 27541) |
| 207P00000X Emergency Medicine (Licence: NH LT4402) | |
| 207R00000X Internal Medicine (Licence: PA MD445231) | |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2023-11-20 |