| NPI | 1528756897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA OT024949) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151016006) |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2026-04-18 |