| NPI | 1558334854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA PAMD030651E) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD030651E) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2014-09-15 |