| NPI | 1568560746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 333501) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD429196) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2025-07-01 |