| NPI | 1558507137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD439693) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 250451) |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2024-01-29 |